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CMA urges Congressional committees to repeal IPAB

March 09, 2012

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Last week both the House Energy and Commerce Health Subcommittee and full committee voted to approve legislation (H.R. 452) to repeal the Medicare Independent Payment Advisory Board (IPAB), a panel established by the Affordable Care Act that would begin making annual recommendations to Congress in 2014 to achieve specified levels of Medicare savings. In late February, the California Medical Association (CMA) and 24 other organizations representing 350,000 doctors signed a letter asking the committee to repeal IPAB. CMA is gratified that the committees moved quickly on this issue.

The letter to the committee chairs stated: “Major health policy decisions will rest in the hands of 15 unelected and largely unaccountable individuals.” Fewer than half of the IPAB members can be health care providers, and none are permitted to be practicing physicians.

“Even worse,” the letter said, “if IPAB fails to report recommendations or never becomes operational, this power will rest solely in the hands of a single individual – the Secretary of the Department of Health and Human Services. Not only does the creation of IPAB severely limit congressional authority, it essentially eliminates the transparency of hearings, debate and a meaningful opportunity for critical stakeholder input.”

Comparing the IPAB to the sustainable growth rate (SGR) formula, the letter said that the IPAB will be required to recommend cuts “based on unrealistic spending targets in 2014. American’s physicians are concerned that strict budgetary targets and other limitations imposed on the panel will ultimately threaten the ability of the nation’s seniors and disabled to obtain health care,” because the cuts directed by the IPAB may disproportionally fall on physicians.

The House Ways and Means Committee is expected to mark up the bill and then pass it out to the House floor sometime in June.

Despite the momentum in the House, the Medicare IPAB enjoys bipartisan support in the Senate and it is unlikely to be overturned. However, CMA will continue to push for its ultimate repeal.